Acupuncture Health Article

Definition

Acupuncture, one of the main forms of therapy in traditional Chinese medicine (TCM), has been practiced for at least 2,500 years. In acupuncture, certain points on the body associated with energy channels or meridians are stimulated by the insertion of fine needles. Unlike the hollow hypodermic needles used in mainstream medicine to give injections or draw blood, acupuncture needles are solid. The points can be needled between 15 and 90 degrees in range relative to the skin's surface, depending on treatment.

Acupuncture is thought to restore health by removing energy imbalances and blockages in the body. Practitioners of TCM believe that there is a vital force or energy called qi(pronounced "chee") that flows through the body, and between the skin surface and the internal organs, along channels or pathways called meridians. There are 12 major and 8 minor meridians. Qi regulates the spiritual, emotional, mental, and physical harmony of the body by keeping the forces of yin and yang in balance. Yang is a principle of heat, activity, brightness, outwardness, while yin represents coldness, passivity, darkness, interiority, etc. TCM does not try to eliminate either yin or yang, but to keep them in harmonious balance. Acupuncture may be used to raise or lower the level of yin or yang in a specific part of the body in order to restore the energy balance.

Acupuncture was virtually unknown in the United States prior to President Nixon's trip to China in 1972. A reporter for the New York Timesnamed James Reston wrote a story for the newspaper about the doctors in Beijing who used acupuncture to relieve his pain following abdominal surgery. By 1993, Americans were making 12 million visits per year to acupuncturists, and spending $500 million annually on acupuncture treatments. By 1995, there were an estimated 10,000 certified acupuncturists practicing in the United States; as of 2000, there were 20,000. About a third of the credentialed acupuncturists in the United States as of 2002 are MDs.

Acupuncture's record of success has been sufficiently impressive to stimulate a number of research projects investigating its mechanisms as well as its efficacy. Research has been funded not only by the National Center for Complementary and Alternative Medicine (NCCAM), but also by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Dental Research, the National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute on Drug Abuse. In 1997 a consensus panel of the National Institutes of Health (NIH) presented a landmark report in which it described acupuncture as a sufficiently promising form of treatment to merit further study. In 2000, the British Medical Association (BMA) recommended that acupuncture should be made more readily available through the National Health Service (NHS), and that family doctors should be trained in some of its techniques.

Purpose

As already noted, the purpose of acupuncture in TCM is the rebalancing of opposing energy forces in different parts of the body. In Western terms, acupuncture is used most commonly as an adjunctive treatment for the relief of chronic or acute pain. In the United States, acupuncture is most widely used to treat pain associated with musculoskeletal disorders, but it has also been used in the treatment of substance abuse, and to relieve nausea and vomiting. A study done in 2001 showed that acupuncture was highly effective in stopping the intense vomiting associated with a condition in pregnant women known as hyperemesis gravidarum. In the past several years, acupuncture has been tried with a new patient population, namely children with chronic pain syndromes. One study of 30 young patients with disorders ranging from migraine headaches to endometriosis found that 70% felt that their symptoms had been relieved by acupuncture, and described themselves as "pleased" by the results of treatment. In addition to these disorders, acupuncture has been used in the United States to treat asthma, infertility, depression, anxiety, HIV infection, fibromyalgia, menstrual cramps, carpal tunnel syndrome, tennis elbow, pitcher's shoulder, chronic fatigue syndrome, and postoperative pain. It has even been used in veterinary medicine to treat chronic pain and prevent epileptic convulsions in animals. As of 2002, NCCAM is sponsoring research regarding the effectiveness of acupuncture in the rehabilitation of stroke patients.

The exact Western medicine mechanism by which acupuncture works is not known. Western researchers have suggested three basic explanations of acupuncture's efficacy in pain relief:

• Western studies have found evidence that the traditional acupuncture points conduct electromagnetic signals. Stimulating the acupuncture points causes these signals to be relayed to the brainat a higher than normal rate. These signals in turn cause the brain to release pain-relieving chemicals known as endorphins, and immune system cells to weak or injured parts of the body.
• Other studies have shown that acupuncture activates the release of opioids into the central nervous system. Opioids are also analgesic, or pain-relieving compounds.
• Acupuncture appears to alter the chemical balance of the brain itself by modifying the production and release of neurotransmitters and neurohormones. Acupuncture has been documented to affect certain involuntary body functions, including immune reactions, blood pressure, and body temperature.

In addition to its efficacy in relieving pain and other chronic conditions, acupuncture has gained in popularity because of several additional advantages:

• It lacks the side effects associated with many medications and surgical treatments in Western medicine.
• It is highly cost-effective; it may be used early in the course of a disease, potentially saving the patient the cost of hospitalizations, laboratory tests, and high-priced drugs.
• It can easily be combined with other forms of therapy, including psychotherapy.
• It is noninvasive.
• It carries relatively few risks.